Provider Demographics
NPI:1770333452
Name:SUNSHINE BEHAVIORAL CARE
Entity type:Organization
Organization Name:SUNSHINE BEHAVIORAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIYAHU
Authorized Official - Middle Name:
Authorized Official - Last Name:KONOVITCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-276-0626
Mailing Address - Street 1:46 WASHINGTON AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2906 S FALKENBURG RD
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33578-2554
Practice Address - Country:US
Practice Address - Phone:877-276-0626
Practice Address - Fax:800-378-7240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst